Patient Care That Is Compassionate, Appropriate, and Effective for the Treatment of Health

KU School of Medicine – Phase II/III Clinical Performance Rating

Student: ______Evaluator:______Campus:KCWDate:______

Clerkship: Amb. Med./GerFam. Med.Int. Med.NeuropsychOb/GynPedsSurgeryOther:______

DIRECTIONS: Please circle the statement that best describes the student’s performance

PATIENT CARE:Student is learning the skills necessary to provide care that is compassionate, appropriate, and effective.

HISTORY TAKING/ REVIEW OF DATA

Incomplete, Inaccurate, disorganized / Frequently misses relevant data; may not focus on key areas / Adequately elicits relevant data / Elicits data in highly satisfactory manner, usually accurate & complete / Exceptional ability to elicit a thorough history, very well organized / Not Observed /
Not Applicable

EXAMINATION(general physical examination and focused exam, e.g., mental status exam, pelvic exam, pregnant woman exam, etc.)

Often misses major, important findings / Frequently makes inaccurate findings / Satisfactorily identifies findings accurately / Highly satisfactory in accurately identifying important findings / Excellent ability to accuratelyidentify physical findings / Not Observed /
Not Applicable

CLINICAL REASONING

Illogical or little effort made / May be illogical or impractical / Typicallylogical & practical, but with significant error rate / Usually logical practical with low error rate / Accurate and insightful / Not Observed /
Not Applicable
MEDICAL KNOWLEDGE:Student is learning to apply their knowledge of biomedical, clinical, and social sciences effectively topatient care.

Preparation for Rounds/ Small Groups / didactics

Usually unprepared, poor understanding of disease processes / Fair preparation; minor deficiencies in understanding of disease processes / Adequately prepared, adequate understanding of disease processes / Well prepared, highly satisfactory understanding of disease processes / Exceptionally well prepared, excellent understanding of disease processes / Not Observed /
Not Applicable
Practice-Based Learning Improvement:Student is learning to use evidence and methods to investigate, evaluate, improve patient care.

SELF-EVALUATION / SELF-AWARENESS

Lacks insight, resists/ignores feedback / Limited insight; resists/ignores some feedback / Average insight; incorporates some feedback / Good insight, incorporates feedback / Exceptional insight, incorporates feedback / Not Observed /
Not Applicable

USE OF TOOLS/INFORMATION TO IMPROVE THEIR KNOWLEDGE, SKILLS & ATTITUDES

Fails to use information technology. / Limited use of information technology. / Average use of technology. / Good use of technology. / Outstanding use of technology. / Not Observed /
Not Applicable
Interpersonal Communication Skills:Student is learning effective communication skills and maintains professional and therapeutic relationships.

RAPPORT / Relationships with others

Relationships are dysfunctional. / Relationships aresuperficial or awkward. / Adequate professional relationships, empathy & rapport. / Highly satisfactory rapport empathy. Relationships are professional. / Exceptional at establishing therapeutic relationshipsworking with the team. / Not Observed /
Not Applicable
Interpersonal & Communication Skills:Student is learning effective communication skills and maintains professional and therapeutic relationships.

Oral & Written communication

Disorganized, unable to communicate thoughts & facts. Uses incorrect & vague terminology, illegible. / Often illegible or inaccurate. May be disorganized & may use incorrect & vague terminology / Clear, organized; accuracy is satisfactory, adequate synthesis / Well organized, accurateshows good synthesis. / Remarkably well organized, concise, accurate, shows outstanding synthesis / Not Observed /
Not Applicable
Professionalism:Student demonstrates behaviors that reflect ongoing commitment to continuous professional development, ethical practice, sensitivity to diversity.

RELIABILITY/DEPENDABILITY/HONESTY

Lacks integrity and dedication, unreliable. / Marginal dedication, reliability & integrity. / Dependable; honest, reliable. / Very Dependable, reliable, dedicated. / Remarkable dedication, reliability and integrity / Not Observed /
Not Applicable

RESPECT FOR PATIENTS & FAMILIES

Disrespectful; Doesn’t maintain patient confidentiality. / Superficial engagement with patient and families. / Respectful; maintains patient confidentiality. / Very respectful and sensitive to patient needs. / Keenly aware of patient/family concerns, remarkably skillful at assessing patient issues. / Not Observed /
Not Applicable
Systems-Based Practice:Student is learning to understandand demonstrate knowledge of optimal health care delivery.

Health Care Delivery System

Does not understand the role of non-physician team members. / Unsure of all team member roles or how best to utilize them. / Can define the role of team members. Satisfactory understanding of systems forhealth care. / Can define the roles of team members. Highly satisfactory understanding of systems for health care. / Exceptionally effective at consulting with health care team to provide optimal patient care. / Not Observed /
Not Applicable
Overall clinical PERFORMANCE RATING(US or LS ratings suggest remedial work is needed)
Unsatisfactory
(59% & Below) / Low Satisfactory
(60% – 69%) / Satisfactory
(70% – 79%) / High Satisfactory
(80% – 89%) / Superior
(90% – 100%)
Required comments that maybe used for Chairman’s and/or Dean’s Letter / General comments not intended for Chairman’s and/or Dean’s Letter

By signing below you are indicating that the ratings above were discussed with the student.

Signatures:Student______Evaluator______

Status:[] Faculty Member,[] Resident, []Other: ______

Clinical Performance Rating